Abstract

Background It is well documented that early interventions of conservative treatment, including training, of OA of the knee are beneficial. It is further stated that communication among levels of the health services is beneficial due to outcome of treatment. Still it seems that these recommendations are not met in the day to day clinical practice in OA rehabilitation.

Objectives To asses how communication is conducted between one orthopedic surgeon and local physiotherapists regarding newly diagnosed patients with OA of the knee and to asses the treatment given by the physiotherapists.

Methods 18 newly diagnosed patients with OA of the knee who was remitted to physiotherapy were identified. All patients was remitted by the same orthopedic surgeon. A letter was sent to the patients asking what local physiotherapist they had been consulting. After receiving 15 answers from the patients a second letter was sent to the physiotherapists asking for discharge reports regarding the patients identified and used in this study. Treatment given by the physiotherapists were identified from the received discharge reports and divided in: Cardiovascular training, strength training, local endurance, mix of local endurance and strengthening exercises and unknown/not possible to perceive from the discharge report.

Results The orthopedic surgeon had not received any discharge reports from any of the physiotherapists by the start of the study. We received 9 (75%) discharge reports after the first letter, and 3 more after a follow up letter (80%). It was conducted 221 treatments on 11 patients (for 1 of the patients the number of treatments are unknown). 7 (58%) had received local endurance, 3 (25%) had received a mix of local endurance and strengthening exercises, 2 (17%) the treatment is unknown. None of the discharge reports contained any objective parameters of evaluation regarding initial status or progression of the patients.

Conclusions Although the compliance in this study is high (80%) there seems to be a lack of communication between professions and levels of health care. None of the physiotherapists had sent discharge reports initially although this is supposed to be sent routinely. Although the initial diagnosis was the same the treatment given varies widely. It seems to be a need for further initiatives regarding communication between professions and levels of health care to ensure predictable, evidence based treatment of OA of the knee. Further research with a larger sample size is needed to confirm these findings.

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